Welcome to the middle path

Sporadic photos and notes from a Psyche-midwife, cheerleader, anthropologist--aka clinical social worker in therapy practice. Photos are usually mine except for those of historical events/famous people. Music relevant to the daily topic is often included in a web video embedded below the blog. Click on highlighted links in the copy to get to source or supplemental material. For contact information, see my website @ janasvoboda.com or click on the button to the right below. Join in the conversation.

Monday, October 24, 2011

The Incredible Heaviness of Being: Braving The Stigma of Mental Illness

Kay Redfield Jamison wears many distinguished hats. A PhD psychologist, she is a tenured professor of Psychiatry at the prestigious John Hopkins school of medicine. She's been honored by Time Magazine as a "Hero of Medicine", and is the author of at least two international bestsellers and over a hundred published research articles. She's had dozens of fellowships, lectureships, and national awards. She's received the MacArthur "Genius" Fellowship.

She also has, and she will be the first to tell you this, a serious mental illness.

Dr. Jamison first became ill with Bipolar Disorder as a senior in high school. In her conservative Episcopalian family, mental illness was not discussed, and if anyone noticed how she was floundering, it wasn't remarked upon. But she noticed. She noticed the long periods of high creativity and energy followed by the much less tolerable periods of complete, abject and suicidal depression. The story of these, and her later complete psychotic break and serious suicide attempt, are charted in vivid and heartbreaking detail in her books "The Unquiet Mind" and "Touched with Fire: Manic-Depressive Illness and the Artistic Sentiment".

It's unusual for a PhD (as opposed to an MD) to be offered a professorship in psychiatry. But that rarity pales in comparison to the level of support her employers at John Hopkins gave her for being "out" with her illness. In an unusual display of wisdom and compassion, her mentors allowed her to continue to pursue her work after her first major break and hospitalization. And her direct supervisor urged her to use the experience of her illness to teach and write. As a result, we have what has been called the classic textbook on Bipolar illness (then called Manic Depressive Disorder), countless research studies, and an example of human courage exemplified. If she had been dismissed, marginalized-- if she had her license to practice revoked (none of these are unusual situations in our culture, when ignorance is faced with illness)-- we would have none of these great works, which have done much to encourage understanding and treatment.

But it is not only the compassion of her employer responsible. It is her courage in saying: "Yes, I have an illness. It is genetic. It is not my choice, but it is my responsibility to manage". Her bravery has had a profound effect in showing people that "different" is not always hopeless.

Dr. Jamison would tell you, as she did the audience of several hundred at OSU tonight, that having BP is not an easy path. In fact, (and I disagree with her, but I don't have her direct experience to effectively contradict) she says that having a mental illness is "99.5% bad". As in my last post, I strongly believe that it was her experience of the illness and her ability to humanize and integrate it that led to some of her greatest gifts.

I don't have much to add to information about Bipolar that colleague and expert on affective disorders psychiatrist James Phelps has not already said, much more brilliantly than I could. If you've not visited his website, I urge you to do so. (If you or someone you love has BP, get his book as well). I would add a bit to Dr. Jamison's speech, though. I'd add that there are some effective management techniques other, or in addition, to medication when folks with affective disorders aren't significantly impaired or completely disabled by their affective differences. You can read about these on Dr. Phelp's site. I would take issue with calling those without BP "normal", because I just haven't met anyone who truly fits that description-- we ALL have our stuff. I think her point in repeatedly saying "mental illness" was to get across that these impairments are not any more chosen, or morally suspect, than having asthma or cardiac disease. And the outcomes of not treating this illnesses are profound: 50% of persons meeting criteria for Bipolar Disorder attempt suicide. 10% succeed. That's a very lethal illness.

In some ways, it is easier than ever to get treatment for affective and other dis-eases of the mind. You can google, ask your MD, look in the yellow pages. In other ways, it is harder than ever. There is still a lot of stigma and ignorance about illnesses and differences that affect our minds and behavior. And even though literature reports that lifestyle changes and therapy support are as effective or increase effectiveness over medication alone, insurance often won't pay for counseling. Certainly not everyone has insurance. Your local NAMI chapter can help you find resources and support. If you are a student, contact your education counseling center to see what low-fee or free services are available. If not, call your local mental health center (God. politicians and voters willing that you still have one). If all else fails, call a crisis line. There are many you can find on the web.

3 comments:

Thank you for the useful resources and tips. The suffering of this and other mental illnesses is really staggering. It makes me really sad and angry; I meet so few people like Dr Jamison who function so well.

Anon--Not to quibble, but you meet so few that are functioning well that have come out as having that difference. It's not typical to be so open as Dr. Jamison has been. Check out this article about Dr. Marsha Linehan, founder of DBT:Expert on Mental Illness Reveals Her Own Fighthttp://www.nytimes.com/2011/06/23/health/23lives.html?pagewanted=allJana